Disparities in oral health status within institutional settings: the increasing need for oral health professionals that are prepared to serve these populations

The aging U.S. population accompanied by the increases in the number of residents permanently living in institutionalized facilities (including nursing homes and correctional facilities) has a created a need for health care providers that are adequately trained to provide them with comprehensive care. This has subsequently created a need for more oral health providers that are trained to serve this population. This study aims to determine the overall oral health status of populations living in two specified institutionalized settings: nursing homes and state prisons within the US. A broad assessment of the common challenges in providing Oral Health Care to these groups along with the disparities that affect them disproportionately may improve the future care provided to them. As well as potentially improve the training and motivation of more oral health professionals to meet their needs. In order to adequately assess this challenge, several research studies at both nursing homes and a state prison in the US were identified and analyzed. According to the CDC, the estimated number of people in the US utilizing nursing facilities is expected to increase from 15 million in 2000 to 27 million by 2050. This also includes alternative residential care places and home care services so for the purposes of this analysis, we will only consider the provision of care in institutions from nursing homes. And as of 2013, there were 15,700 Medicare certified nursing homes in the U.S. It’s no secret that aging baby boomers are and will result in a much older U.S. over the next decade. According to CDC’s review on Long-term Care Services in the U.S.: 2013, the number of Americans in the U.S. over the age of 65 is expected to double (from 40.2 million to 88.5 million) from 2010 to 2050 This population group is more likely to need long-term care services in the areas of health, personal care, and general support because of their limited capacity for self-care; specifically oral health care. Xerostomia, commonly referred to as “dry mouth,” edentualism, and overall poor oral hygiene were among the most common concerns among elderly patients in nursing home. But with the increase of natural teeth retention into older age, there has been a subsequent increase in the risk of periodontal disease and tooth decay (Friedman et al., 2014). The US Federal Bureau of Prisons (FBOP) is the largest correctional jurisdiction in the US and is made up of 119 prisons and over 216,000 prisoners. While healthcare is under the direction of a Chief Medical Officer, oral healthcare is controlled by a chief dentist who further delegate the duties to regional chief dentists. But despite a highly organized division of health care within correctional facilities, inmates still have a severe compromised oral health due to drug abuse. This usage results in increased instances of dental disease and pain that often go unnoticed among this institutionalized population. Whether or not there will be enough qualified dental providers to fill the needs of this group remains an important issue for current and future oral health professionals

Plan de Gestión metodológica en aprendizajes significativos

PDFEl presente trabajo tiene como propósito cambiar los procesos pedagógicos para el logro de un aprendizaje significativo en los estudiantes de la carrera de Técnicos Superior de Enfermería. El problema de la investigación radica en el proceso de enseñanza con prácticas pedagógicas inadecuadas las que responden al modelo educativo tradicionalista, que a pesar de las alternativas de superación aplicadas en el contexto institucional y la búsqueda constante de los docentes en sus funciones académicas, aún persisten problemas relacionados en el cómo enseñar desde un aprendizaje significativo, debido a que el personal docente de la Institución está formado por profesionales de la salud, la mayoría sin formación docente ni pedagógica, esto hace que el proceso enseñanza aprendizaje no se desarrolle aplicando herramientas pedagógicas adecuadas. El marco teórico está compuesto por una amplia revisión bibliográfica de los estudios científicos que se han realizado sobre la gestión pedagógica y el logro de un aprendizaje significativo, analizando los fundamentos filosóficos, epistemológicos, andragógicos, sociológicos y psicológicos en el proceso de enseñanza aprendizaje. La metodología de la investigación se basa en el paradigma cuali-cuantitativo de proyecto factible mediante la investigación bibliográfica documental y de campo, los resultados fueron sometidos al análisis en el que se confirma que el problema planteado es factible de resolver con la propuesta de un plan de gestión metodológica en aprendizaje significativo. Los beneficiarios de la presente tesis de grado son los estudiantes de la carrera Técnico Superior de Enfermería. El impacto se logra en la sociedad que será atendida por un personal con una formación de calidadThe main goal of the present investigation work is to change the pedagogical processes in the achievement of a significant learning in the Superior Technical Nursing students. The object of investigation focuses in the teaching process with inadequate pedagogical techniques that answer to the traditionalist educational model, that despite of the improvement alternatives applied in the institutional context and constant pursuit of the teachers in their academic functions, it still remains some problems related to how to teach with a significant learning, due to the institution´s teachers is conformed for health professionals, most of them without teaching or pedagogical formation, this makes the teaching-learning process doesn´t develop using the proper pedagogical tools. The theoretical framework is conformed for a wide literature review of th e scientific studies that has been realized about the pedagogical management and the achieves of the significant learning, analyzing the philosophical, epistemological, andragogical, sociological and psychological principles in the process of the significant learning. The investigation methodology is based on the qualitative and quantitative paradigm of feasible project by the bibliographic investigation by documentary and field, the results were submitted to analysis in which it´s confirmed that the problem raised is feasible to solve with the proposal of a plan of methodological management in the significant learning. The beneficiaries of the present graduation thesis are the Superior Technical Nursing students. The direct impact is achieved in the society that will be served by a personal with a quality training.Instituto de Pos-Grado y Educación Contínua; Maestría en Gerencia Educativ

Host and bacterial factors that regulate LC3 recruitment to Listeria monocytogenes during the early stages of macrophage infection

Listeria monocytogenes is a bacterial pathogen that can escape the phagosome and replicate in the cytosol of host cells during infection. We previously observed that a population (up to 35%) of L. monocytogenes strain 10403S colocalize with the macroautophagy marker LC3 at 1 h postinfection. This is thought to give rise to spacious Listeria-containing phagosomes (SLAPs), a membrane-bound compartment harboring slow-growing bacteria that is associated with persistent infection. Here, we examined the host and bacterial factors that mediate LC3 recruitment to bacteria at 1 h postinfection. At this early time point, LC3+ bacteria were present within single-membrane phagosomes that are LAMP1+. Protein ubiquitination is known to play a role in targeting cytosolic L. monocytogenes to macroautophagy. However, we found that neither protein ubiquitination nor the ubiquitin-binding adaptor SQSTM1/p62 are associated with LC3+ bacteria at 1 h postinfection. Reactive oxygen species (ROS) production by the CYBB/NOX2 NADPH oxidase was also required for LC3 recruitment to bacteria at 1 h postinfection and for subsequent SLAP formation. Diacylglycerol is an upstream activator of the CYBB/NOX2 NADPH oxidase, and its production by both bacterial and host phospholipases was required for LC3 recruitment to bacteria. Our data suggest that the LC3-associated phagocytosis (LAP) pathway, which is distinct from macroautophagy, targets L. monocytogenes during the early stage of infection within host macrophages and allows establishment of an intracellular niche (SLAPs) associated with persistent infection

Dynamic Behavior of Salmonella-Induced Membrane Tubules in Epithelial Cells

Salmonella Typhimurium is a facultative intracellular pathogen that causes acute gastroenteritis in man. Intracellular Salmonella survive and replicate within a modified phagosome known as the Salmonella-containing vacuole (SCV). The onset of intracellular replication is accompanied by the appearance of membrane tubules, called Salmonella-induced filaments (Sifs), extending from the SCV. Sifs are enriched in late endosomal/lysosomal membrane proteins such as lysosome-associated membrane protein 1, but their formation and ability to interact with endosomal compartments are not characterized. In this study, we use live cell imaging techniques to define the dynamics of Sif formation in infected epithelial cells. At early time-points, Sifs are simple tubules extending from the surface of SCVs. These tubules are highly dynamic and exhibit bidirectional, microtubule-dependent movement. At the distal ends of individual Sif tubules, furthest from the SCV, a distinct ‘leader’ domain was often observed. At later times, Sifs develop into highly complex tubular networks that extend throughout the cell and appear less dynamic than nascent Sifs; however, individual tubules continue to display bidirectional dynamics. Sifs can acquire endocytic content by fusion, indicating a sustained interaction with the endocytic pathway. Together, these results show that these Salmonella-induced tubules form a highly dynamic network that involves both microtubule-dependent motility and interactions with endosomal compartments

Listeria monocytogenes exploits efferocytosis to promote cell-to-cell spread

Efferocytosis, the process by which dying/dead cells are removed by phagocytosis, plays an important role in development, tissue homeostasis and innate immunity1. Efferocytosis is mediated, in part, by receptors that bind to exofacial phosphatidylserine (PS) on cells or cellular debris after loss of plasma membrane asymmetry. Here we show that a bacterial pathogen, Listeria monocytogenes (Lm), can exploit efferocytosis to promote cell-to-cell spread during infection. These bacteria can escape the phagosome in host cells using the pore-forming toxin Listeriolysin O (LLO) and two phospholipases C2. Expression of the cell surface protein ActA allows Lm to activate host actin regulatory factors and undergo actin-based motility in the cytosol, eventually leading to formation of actin-rich protrusions at the cell surface. We show that protrusion formation is associated with plasma membrane damage due to LLO’s pore-forming activity. LLO also promotes the release of bacteria-containing protrusions from the host cell, generating membrane-derived vesicles with exofacial PS. The PS-binding receptor TIM-4 contributes to efficient cell-to-cell spread by Lm in macrophages in vitro and growth of these bacteria is impaired in TIM-4−/− mice. Thus, Lm promotes its dissemination in a host by exploiting efferocytosis. Our study suggests that PS-targeted therapeutics may be useful in the fight against infections by Lm and other bacteria that utilize similar strategies of cell-to-cell spread during infection

Dynamic glucose uptake, storage, and release by human microvascular endothelial cells

Endothelia determine blood-to-tissue solute delivery, yet glucose transit is poorly understood. To illuminate mechanisms, we tracked [3H]-2-deoxyglucose (2-DG) in human adipose-tissue microvascular endothelial cells. 2-DG uptake was largely facilitated by the glucose transporters GLUT1 and GLUT3. Once in the cytosol, >80% of 2-DG became phosphorylated and ∼20% incorporated into glycogen, suggesting that transported glucose is readily accessible to cytosolic enzymes. Interestingly, a fraction of intracellular 2-DG was released over time (15–20% over 30 min) with slower kinetics than for uptake, involving GLUT3. In contrast to intracellular 2-DG, the released 2-DG was largely unphosphorylated. Glucose release involved endoplasmic reticulum–resident translocases/phosphatases and was stimulated by adrenaline, consistent with participation of glycogenolysis and glucose dephosphorylation. Surprisingly, the fluorescent glucose derivative 2-NBD-glucose (2-NBDG) entered cells largely via fluid phase endocytosis and exited by recycling. 2-NBDG uptake was insensitive to GLUT1/GLUT3 inhibition, suggesting poor influx across membranes. 2-NBDG recycling, but not 2-DG efflux, was sensitive to N-ethyl maleimide. In sum, by utilizing radioactive and fluorescent glucose derivatives, we identified two parallel routes of entry: uptake into the cytosol through dedicated glucose transporters and endocytosis. This reveals the complex glucose handling by endothelial cells that may contribute to glucose delivery to tissues.Fil: Yazdani, Samaneh. University Of Toronto. Hospital For Sick Children; CanadáFil: Bilan, Philip J.. University Of Toronto. Hospital For Sick Children; CanadáFil: Jaldín Fincati, Javier Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Patología Experimental. Universidad Nacional de Salta. Facultad de Ciencias de la Salud. Instituto de Patología Experimental; Argentina. University Of Toronto. Hospital For Sick Children; CanadáFil: Pang, Janice. University Of Toronto. Hospital For Sick Children; CanadáFil: Ceban, Felicia. University Of Toronto. Hospital For Sick Children; CanadáFil: Saran, Ekambir. University Of Toronto. Hospital For Sick Children; CanadáFil: Brumell, John H.. University Of Toronto. Hospital For Sick Children; Canadá. University of Toronto; CanadáFil: Freeman, Spencer A.. University Of Toronto. Hospital For Sick Children; Canadá. University of Toronto; CanadáFil: Klip, Amira. University of Toronto; Canadá. University Of Toronto. Hospital For Sick Children; Canad

Salmonella typhimurium SifA effector protein requires its membrane-anchoring C-terminal hexapeptide for its biological function

SifA is a Salmonella typhimurium effector protein that is translocated across the membrane of the Salmonella-containing vacuole by the Salmonella pathogenicity island 2-encoded type III secretion system. SifA is necessary for the formation ofSalmonella-induced filaments and for the maintenance of the vacuolar membrane enclosing the pathogen. We have investigated the role of the C-terminal hexapeptide of SifA as a potential site for membrane anchoring. An S. typhimuriumstrain carrying a deletion of the sequence encoding this hexapeptide (sifAΔ6) was found to be attenuated for systemic virulence in mice. In mouse macrophages, sifAΔ6 mutant bacteria displayed a reduced association with vacuolar markers, similar to that of sifA null mutant bacteria, and exhibited a dramatic replication defect. Expression of SifA in epithelial cells results in the mobilization of lysosomal glycoproteins in large vesicular structures and Sif-like tubules. This process requires the presence of the C-terminal hexapeptide domain of SifA. Ectopic expression of truncated or mutated versions of SifA affecting the C-terminal hexapeptide revealed a strong correlation between the membrane binding capability and the biological activity of the protein. Finally, the eleven C-terminal residues of SifA are shown to be sufficient to target the Aequorea green fluorescent protein to membranes. Altogether, our results indicate that membrane anchoring of SifA requires its C-terminal hexapeptide domain, which is important for the biological function of this bacterial effector

SopB promotes phosphatidylinositol 3-phosphate formation on Salmonella vacuoles by recruiting Rab5 and Vps34

Salmonella colonizes a vacuolar niche in host cells during infection. Maturation of the Salmonella-containing vacuole (SCV) involves the formation of phosphatidylinositol 3-phosphate (PI(3)P) on its outer leaflet. SopB, a bacterial virulence factor with phosphoinositide phosphatase activity, was proposed to generate PI(3)P by dephosphorylating PI(3,4)P2, PI(3,5)P2, and PI(3,4,5)P3. Here, we examine the mechanism of PI(3)P formation during Salmonella infection. SopB is required to form PI(3,4)P2/PI(3,4,5)P3 at invasion ruffles and PI(3)P on nascent SCVs. However, we uncouple these events experimentally and reveal that SopB does not dephosphorylate PI(3,4)P2/PI(3,4,5)P3 to produce PI(3)P. Instead, the phosphatase activity of SopB is required for Rab5 recruitment to the SCV. Vps34, a PI3-kinase that associates with active Rab5, is responsible for PI(3)P formation on SCVs. Therefore, SopB mediates PI(3)P production on the SCV indirectly through recruitment of Rab5 and its effector Vps34. These findings reveal a link between phosphoinositide phosphatase activity and the recruitment of Rab5 to phagosomes